Prostate cancer is the 2nd most common cancer in men, after skin cancer. There were 1,276,106 prostate cancer cases diagnosed worldwide in 2018. It constitutes 7.5% of all cancers, excluding non-melanoma skin cancer.
In India, prostate cancer accounts for 7% of all cancers and is the 3rd leading cancer in men. Since the 1990s, the number of cases of prostate cancer has shot up over 220%. It is expected to grow exponentially in the coming years. About 1 man in 41 will die of prostate cancer in America alone, according to recent reports.
Prostate cancer is a very common type of cancer in men with an increasing incidence globally due to changing lifestyles, stress, pollution, unhealthy habits, and more. However, another reason for the increased incidence is the increased availability of screening for prostate-specific antigen (PSA) in men without symptoms of the disease. So, that is not bad news. If you or your loved one suspect prostate cancer, you should immediately consult an expert, like Dr. P.K.Das, a top prostate cancer specialist in Delhi, for the best treatment, care, & support available.
The prostate is a small walnut-shaped gland below the bladder and right in front of the rectum in men. It produces & stores fluid that helps to make semen. Prostate cancer occurs due to an uncontrolled/malignant growth of cells in the prostate gland. The organ can be examined by a digital rectal exam.
The type of prostate cancer tells the doctor about the cell where the cancer started. Understanding & knowing this helps a specialist decide which treatment plan the patient needs.
Ductal adenocarcinoma begins in the cells lining the ducts/tubes of the prostate gland. It generally grows and spreads quicker than acinar adenocarcinoma.
Transitional cell cancer of the prostate begins in the cells lining the tube carrying urine out of the body (the urethra). This cancer generally starts in the bladder, spreading into the prostate.
Squamous cell cancer develops from flat cells covering the prostate. They generally grow and spread quicker than adenocarcinoma of the prostate. Though infrequent, the aggressive malignancy of squamous cell cancer is found in less than 1% of men globally.
Small cell carcinoma of the prostate or SCCP is a subset of neuroendocrine cancer. It is a rare malignancy affecting <1% of the population. It is made up of small round cells & considered a lethal entity of prostate cancer.
Prostate cancer can be classified into 4 different stages, depending on how advanced it is.
Prostate cancer is difficult to detect. Like other cancers, it begins as a small, slow-growing tumor that can quickly grow into a more advanced form.
It is important to understand the stages of prostate cancer that it can progress through. Once your doctor knows this information, they will make sure you receive the best treatment possible by detecting and targeting those stages of the disease early enough.
Research has shown that some types of treatment for prostate cancer are more effective when started as soon as possible after diagnosis, while others work better if started later on in the disease process – this helps identify which treatments will be most effective for an individual man.
Now, the 4 stages of prostate cancer are:
Stage 1 prostate cancer is the least advanced form of it. At this stage, the cancer is small and hasn’t spread past the prostate gland. PSA of less than 10 ng/mL, a grade group score of 1, and a Gleason score of 6 characterize the cancer at this point. Stage 1 prostate cancer has a 5-year survival rate of almost 100%.
In the second stage of prostate cancer, the tumor is still confined to the prostate and has not spread to either the lymph nodes or the other parts of the body. While the tumor might not be felt by the doctor during a prostate exam, it may appear on ultrasound imaging. This stage is divided into 3 phases, 2A, 2B, & 2C. The stage 2 PSA score is less than 20 ng/mL. The survival rate at this stage is at nearly 100%.
At stage 3 the prostate cancer is locally advanced. The tumor has progressed & is estimated to grow and spread with the Gleason score & PSA being high as well. If the prostate cancer hasn't spread to distant body parts, the survival rate is close to 100%. It has 3 phases/substages 3A, 3B, & 3C.
In stage 4, prostate cancer has spread to the lymph nodes or other body parts or both. It is the most advanced stage of prostate cancer. If the cancer has spread to other body parts, the 5-year survival rate falls to about 30%. It has two substages or phases 4A and 4B depending on where the cancer has spread.
While prostate cancer patients may not experience any symptoms, some of the common symptoms/signs include:
It is important to note that these symptoms may be caused by other unrelated causes as well.
Symptoms for cases where the cancer has spread outside the prostate gland:
The exact cause of prostate cancer is not known. In most cases, multiple factors, including genetics, an encounter with environmental toxins (radiation or chemicals), and more may be involved.
Conclusively, mutations in the DNA or genetic material primarily lead to the proliferation of cancerous cells. These abnormal or cancerous cells continue to grow and multiply until a tumor develops. In the case of an aggressive type of prostate cancer, the cells may metastasize, leaving the original tumor site and spreading to other parts of your body.
The risk of disease increases with age. 60% of cases are reported in people 65 years or older.
People with African ancestry are more likely to be diagnosed with prostate cancer.
A previous family history of prostate cancer increases the risk of getting prostate cancer.
Some studies suggested that eating foods high in fat, especially animal fat, regularly are a risk factor.
It is more common in North America, the Caribbean, northwestern Europe, and Australia than in Asia, Africa, Central America, and South America.
Prostate cancer screening in healthy men is a controversial topic. But men in their 50s and above are advised to discuss the pros & cons of prostate cancer screening by doctors.
The screening tests may include:
A DRE involves a doctor inserting a gloved, lubricated finger into the patient’s rectum to examine the prostate. If any abnormality of texture, shape, or size is found, further tests are required.
To do the PSA test, a blood sample is drawn from the patient and analyzed for PSA, a naturally produced substance by the prostate gland. If higher than usual PSA is found, it may indicate several issues, including prostate infection, inflammation, enlargement, or cancer.
For prostate cancer, transrectal ultrasound is used. During the exam, a small probe sized close to a cigar is inserted into the rectum. It uses sound waves to create an image of the prostate gland.
For some individuals, a doctor may recommend an MRI scan. This test creates a more detailed image of the prostate gland. It can help the doctor plan a personalized procedure to remove the prostate tissue samples as required.
To have a clear idea about whether the cells in the prostate are cancer cells or not, a doctor may recommend a procedure to collect tissue samples from the prostate gland. This procedure uses a thin needle to collect the tissue, and then the sample is analyzed in a lab to detect cancer.
Being the best medical oncologist in Delhi, Dr. P.K. Das and his team offer the latest prostate cancer treatments to patients.
In some cases where immediate treatment is not necessary because the patient might already be suffering from serious ailments & have a life expectancy of lesser than 5 years. Active surveillance or watchful waiting might be suggested in these cases. If the patient experiences symptoms of prostate cancer, the symptoms are relieved with treatments like hormonal therapy.
In some cases where cancer has not spread beyond the prostate, surgery might be an option where the prostate gland, certain surrounding tissue, and some lymph nodes are removed. The surgery, radical prostatectomy, can be done either through robot-assisted laparoscopy (more common) or through a long incision on the lower abdomen (less common).
Radiation therapy which uses high-powered beams to kill cancer cells can be used in certain cases of prostate cancer. Two kinds of radiation therapies are used in prostate cancer-external beam radiation and brachytherapy. While external beam radiation involves radioactive sources outside the body, brachytherapy involves radioactive sources in the prostate tissue. In certain cases, both types may be suggested.
Cryoablation or cryotherapy uses a very cold gas to freeze the prostate tissue, and then it is allowed to thaw & the process is repeated. This kills the cancer cells. HIFU or High-intensity focused ultrasound, on the other hand, heats the prostate tissue causing the cancerous cells to die.
Prostate cancer cells depend on testosterone to grow & hormone therapy stops the body from producing the hormone, either killing the cells or slowing their growth. It may include medications to help the body stop producing the hormones, medications that block the hormone from reaching the cancer cells, or surgery to remove the testicles leading to reduced testosterone levels.
Chemotherapy drugs kill rapidly growing cells, which includes cancer cells. It can be administered either through a vein in the arm, in pill form, or both. It may be an option for treating prostate cancer that has spread to areas other than the prostate gland of the body. It can also be used in cases where hormone therapy has proven unresponsive.
Immunotherapy uses the body’s immune system to fight prostate cancer. The immune system does not attack the cancer cells at first because these cells produce certain proteins that help hide them from the immune system. Immunotherapy interferes with that process allowing the immune system to recognize and fight against cancer cells. Prostate cancer immunotherapy either engineers the body’s cells to fight cancer or help the immune system identify cancer cells.
Targeted therapy focuses on unique precise abnormalities within the cancer cells. The treatment blocks these abnormalities causing cancer cells to die. They are mostly recommended to treat advanced or recurrent prostate cancer in case hormone therapy is not working. Some targeted therapies only work in individuals with cancer cells having specific genetic mutations.
Targeted therapy and immunotherapy in cancer patients, especially prostate cancer patients, are rapidly evolving treatment channels.
If you need a consult, the best treatment options, support, and assistance for prostate cancer, you can connect with Dr. P.K.Das, a leading cancer specialist in Delhi NCR.
Prostate cancer is the 4th most common tumor diagnosed worldwide.
Active surveillance, surgery, & radiation therapy are the major treatments for prostate cancer.
The major side effects of prostate cancer treatment are urinary incontinence, bowel dysfunction, and erectile dysfunction.
Surgery and radiation are the best treatments for early-stage prostate cancer.
The 5-year prostate cancer survival rate in India is 64%.